Remote evaluation of general skin diseases using three-dimensional total body photography: An observer agreement study

Background: Three-dimensional total body photography (3D TBP) is a new tool in dermatology, and its role and value in the diagnosis of skin conditions have been shown for skin malignancies with respectable diagnostic accuracies, but not for other skin diseases. Objectives and methods: To elucidate the value of 3D TBP in general dermatology and to assess the patient's acceptance, we performed an observer agreement study of the diagnoses of 294 patients presenting with skin changes obtained in face-to-face visits versus diagnoses obtained by retrospective analysis of 3D scans without seeing the patients face to face. Additionally, patients’ views on 3D TBP were evaluated using questionnaires. Results: Primary diagnoses in a diverse patient group across a broad range of diagnoses obtained by 2 senior dermatologists (B.E. and A.Z.) independently reviewing 3D TBP scans matched in 68.4% and 81.1% of cases, respectively. Patients expressed mostly positive views on this technology while identifying privacy and shame as barriers to this technology. Limitations and conclusion: Despite being limited by recruitment bias, our study proves the feasibility of diagnosing general skin diseases with tele-3D TBP including a high physicians’ and patients’ acceptance. Further studies are needed to delineate its role in future dermatology health care with a diminishing number of dermatologists.